Individuals working on HIV/AIDS prevention in San Francisco contend that if the city government does not restore millions of dollars in federal cuts, they would lose ground in the fight against the disease. Since the beginning of the epidemic in the 1980s, San Francisco has created a system of care with the Department of Public Health and nonprofit groups. The system relies on federal funding to provide prevention, testing, and treatment services. In December 2011, 15,489 people were living with AIDS in San Francisco. In 1992, there were 2,330 cases diagnosed compared to 2011, when there were only 392 newly diagnosed cases. Lance Toma, executive director of the Asian and Pacific Islander Wellness Center, explained that the funding cuts would cause the work to regress at the time when San Francisco could visualize an AIDS-free generation. Toma and others attended a board of supervisors' budget and finance committee hearing recently to persuade city officials to fill in the federal cuts.

The city experienced a $7.2 million HIV-related reduction in federal funding for this fiscal year, and local taxes revenues had to make up the loss. For the next two fiscal years, the city had been expecting federal cuts of $9.5 million and $10.3 million until it budgeted $5.1 million for each year. That results in shortages of $4.4 million and $5.2 million. The shortages are expected to worsen by at least $1.3 million each year due to federal budget cuts. This is also a difficult time for the city, which is facing a budget deficit of $126 million next fiscal year while the Department of Public Health is asking to meet a $45 million deficit for the current fiscal year. In five years, the total San Francisco budget deficit is expected to grow to $487 million. The mayor has to submit a balanced budget to the board of supervisors for review and adoption by June 3.

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